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Association between milk and dairy product intake and the risk of dental caries in children and adolescents: NHANES 2011-2016

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Background and objectives: To date, few studies have comprehensively explored the associations between milk and dairy product intake and dental caries. Therefore, this study aimed to simultaneously assess the associations between whole milk, low-fat milk, skim milk, yogurt, milk desserts, cheese, creams, and total fluid milk intake and the risk of dental caries in children and adolescents. Methods and study design: Data were from the National Health and Nutrition Examination Survey (NHANES) 2011-2016. Two 24-hour dietary recall interviews measured dietary milk and dairy product intake. Primary teeth caries was diagnosed by the dfs (decayed or filled primary tooth surfaces) index, and permanent teeth caries was diagnosed by the DMFS (decayed, missing, or filled permanent tooth surfaces) index. We used logistic regression to explore the associations between milk and dairy product intake and the risk of dental caries. Results: A total of 6885 individuals aged 2-17 years were included in this study. In the fully adjusted model, the odds ratios (95% confidence intervals) of dental caries were 0.66 (0.47-0.93) for intake ≥123 g/day of yogurt and 0.82 (0.69-0.98) for intake <22.6 g/day of cheese, as compared with non-consumers. Conclusions: Our study indicates that high yogurt and low cheese intake were associated with a decreased risk of dental caries among American children and adolescents. These findings may be applied to update and supplement the evidence that informs public health policies on milk and dairy products and the prevention of dental caries.

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... Erosive wear, on the other hand, has a direct relationship with behavioral determinants such as excessive or erroneous oral hygiene and emotional disorders (Maharani et al., 2019;(Frydrych, et al., 2022). Furthermore, both depend on increased salivary viscosity, contributing to greater food exposure in the oral cavity, increasing the risk of developing caries and dental erosion (Almeida et al., 2016;Woodward & Rugg-Gunn, 2020;Wang et al., 2021). However, these results support possible new studies on the issue of powdered milk and infant formulas with an approach to other factors and new methodologies so that knowledge of applicability in the clinical routine of dentists can be offered. ...
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To estimate Calcium and Phosphorus withdrawal from hydroxyapatite in the presence of bovine milk and human milk from which the following protective fractions namely Casein, Whey protein, Lactose and Milk fat have been individually removed and to compare the above protective fractions in human and bovine milk. Human milk obtained from lactating mothers in the labor ward of Kshema hospital was subjected to immediate analysis. Bovine milk was obtained from a local dairy. Equal quantities of human milk and bovine milk (1 ml) were separately subjected to the systematic removal of the four milk fractions. As each fraction was removed, the remaining milk samples were subjected to testing. Powdered hydroxyapatite from human dental enamel was subjected to demineralization with the addition of the milk sample under test for 20 minutes. This mixture was then centrifuged. Aliquots of the supernatant were taken for calcium and Phosphorus analysis using photospectrometry. Ten demineralization tests were similarly carried out for every milk fraction for both human and bovine milk separately. Equal samples of whole bovine milk and whole human milk were also subjected to similar testing. The calcium and phosphorus dissolution values were higher when the individual fractions were eliminated from both human milk/enamel samples and bovine milk/enamel samples as compared to the values obtained from whole human milk/whole bovine milk/enamel samples. Further higher calcium and phosphorus dissolution values were observed when the fractions were individually and separately removed from the whole human milk/enamel samples as compared to the corresponding values obtained when these fractions were removed from bovine milk/enamel samples. The evaluated milk fraction in bovine milk namely casein, whey protein, lactose and milk fat were individually more caries protective when compared to the corresponding fractions in human milk.
Article
In vitro studies show that milk or milk components may have cariostatic properties. However, the results of epidemiological studies on the association between intake of dairy products and dental caries have been inconsistent. The purpose of this cross-sectional study was to examine the association between intake of dairy products and the prevalence of dental caries in young children. Study subjects were 2058 Japanese children aged 3 years. Information on diet was assessed with a self-administered brief diet history questionnaire for children. The consumption of dairy products was categorized into 3 levels in order to represent the tertiles as closely as possible. Dental caries was assessed by a visual examination. Adjustment was made for sex, toothbrushing frequency, use of fluoride, between-meal snack frequency, maternal smoking during pregnancy, environmental tobacco smoke exposure at home, and paternal and maternal educational levels. Compared with yogurt consumption at the lowest tertile (<1 time/week), its intake at the highest level (> or =4 times/week) was significantly associated with a lower prevalence of dental caries, showing a clear dose-response relationship (adjusted prevalence ratio=0.78, 95% confidence interval: 0.62-0.98, P for trend=0.04). There were no material associations between intake of cheese, bread and butter, or milk and the prevalence of dental caries. These data suggest that a high consumption of yogurt may be associated with a lower prevalence of dental caries in young children.
Article
Casein phosphopeptides (CPPs) are phosphorylated casein-derived peptides produced synthetically by proteolytic digestion of alpha(s1)-, alpha(s2)- and beta-casein. The anticariogenic activity of CPPs is due to their ability to stabilize high levels of amorphous calcium phosphate (ACP) on tooth surface, preventing demineralization and enhancing remineralization of enamel caries. The aim of this study was to test the in vitro ability of natural CPPs (contained in yogurt) to prevent demineralization and promote remineralization of dental enamel. Eighty human molars were used. After standardizing an in vitro demineralization procedure for producing artificial caries (Group 1: pH 4.8; Group 2: pH 3.97), this procedure was used on teeth, but with the addition of natural CPPs (Group 3: pH 4.8; Group 4: pH 3.97). The effects of these procedures were evaluated by quantitative analysis (change in weight and calcium titration) and qualitative analysis (SEM). Statistical analysis of the results was performed using ANOVA. Statistical analysis showed significant differences in weight changes between the groups with and without natural CPPs. The SEM observation showed the protective effects of natural CPPs. The results demonstrated that CPPs contained in yogurt have an inhibitory effect on demineralization and promote the remineralization of dental enamel.
Article
The protective effects of milk and milk products against dental caries have been demonstrated in many animal studies. We have shown that this effect was mediated by micellar casein or caseinopeptide derivatives. A reduction in the Streptococcus sobrinus population in the oral microbiota of animals fed diets supplemented with these milk components was consistently observed. A possible explanation for these findings is that milk components are incorporated into the salivary pellicle, thereby reducing the adherence of S. sobrinus. This hypothesis was tested in vitro by the incubation of bovine enamel discs with unstimulated saliva. The resulting pellicle was washed and incubated with caseinoglycomacropeptide (CGMP) and/or caseinophosphopeptide (CPP) labeled with 17- and 12-nm gold particles. All samples were prepared for electron microscopy by high-pressure freezing followed by freeze-substitution. It was demonstrated by high-resolution scanning electron microscopy with back-scattered electron imaging, as well as by transmission electron microscopy, that both peptides were incorporated into the pellicle in exchange for albumin, confirming previous findings. This protein was identified with a mouse anti-human serum albumin followed by goat anti-mouse IgG labeled with 25-nm gold particles. Incorporation of CGMP and/or CPP into salivary pellicles reduced the adherence of both S. sobrinus and S. mutans significantly. It is suggested that the calcium and phosphate-rich micellar casein or caseinopeptides are incorporated into the pellicle. The resulting ecological shifts, together with the increased remineralization potential of this biofilm, may explain its modified cariogenic potential.
Article
The effect of milk on dental caries was studied on a sample of 6-to-11-year-old Italian schoolchildren. The daily amount of milk consumed and the frequency of consumption of sucrose-containing foods were obtained by a 24-hour dietary diary. In the subsequent oral examination, the level of visible plaque and the number of decayed, extracted and filled teeth (both primary and permanent) of the children were recorded. 439 children (217 boys) who did not use fluoride prophylaxis and with poor oral hygiene were selected from among 890 children. They were divided into three groups according to the frequency of sucrose consumption. The data were statistically analysed using multiple logistic regression. The children consumed a daily average of 209 +/- 133 ml of milk and there were no differences among the three groups in this respect. As expected, the dental health of the children with low sucrose frequency was significantly better than that of the children with high sucrose frequency. The regression on the whole sample showed a weak, significant, negative association between milk consumption and caries (p < 0.05). In the group of high sucrose-consuming children a negative, highly significant association was found (p < 0.001), while in the two groups of low and moderate sucrose-consuming children no association was found. These data suggest that, in the present sample of children who did not use fluoride and with poor oral hygiene, milk has a caries preventive effect only on those subjects with a high daily sucrose-consuming frequency.
Article
This study sought to estimate the prevalence and related prediction factors for dental caries in 3- to 5-year-old children in Rome, Italy. From a sample of 2,025 children, 1,494 (73.8%) were included in the analysis. Children with at least two primary maxillary incisors showing evidence of caries experience were considered affected by rampant early childhood dental decay (RECDD). Behavioral and socioeconomic variables, mutans streptococci counts, diet, and nutritional status were investigated for their association with RECDD using regression analysis. The prevalence of any caries was 27.3 percent, and was 7.6 percent for RECDD. Among all children, mean dft and dt scores per person were 1.1 (SD = 2.4) and 0.9 (SD = 2.3), respectively; among those classified as having RECDD, scores were 6.9 (SD = 4.2) and 6.7 (SD = 4.3), respectively. Children with RECDD had 56 percent of all the decayed teeth in the sample. Low and medium social classes, use of a baby bottle filled with sweetened beverages, high salivary mutans streptococcal levels, and malnutrition were directly associated with RECDD; milk and yogurt consumption and low Plaque Index scores were inversely associated with the condition. The high prevalence of RECDD suggests that the implementation of preventive programs should be a priority for dental public health. Because of its high prevalence among children as young as 3 years of age, preventive measures targeted toward pregnant women and toddlers should be developed and tested, while kindergarten students could be used for monitoring RECDD prevalence and for detection of communities at risk.
Article
To characterise and identify the anti-dental caries components that exist in milk and milk products. Standard enamel or hydroxyapatite demineralisation tests were devised to simulate the action of acid on tooth mineral, and they were used to show which constituents of milk possessed a potential protective action against acid attack. Milk and milk products were fractionated and tested, revealing that minerals, including calcium and phosphorus, played a part in this protective process. The findings also drew attention to the effectiveness of minor milk protein or protein-associated components, the structures of which are mostly known, which were separated and characterised by gel electrophoresis as proteose-peptone fractions 3 and 5. The strength of adsorption of the protein or polypeptides in these fractions to dental enamel was measured and found to be sufficient to reduce the extent of demineralisation of enamel by acid buffer solutions. The removal of lactose, fat, casein and other proteins had little influence on the protective effect of the milk fractions. Besides calcium and phosphorus, milk contains other more powerful protective factors, which were identified as proteose-peptone fractions 3 and 5. Details of their composition and the strength of their adherence to the surface of dental mineral are given.
Article
Whereas research into the causes of dental decay has focused on the harmful relationship between dental plaque bacteria and foods, studies into the protective effects of foods have been infrequent and limited in number. Recent investigations showed that milk and cheese could reduce the effects of metabolic acids, and could help restore the enamel that is lost during eating. Postulated mechanisms involve buffering, salivary stimulation, reduction of bacterial adhesion, reduction of enamel demineralization, and/or promotion of remineralization by casein and ionizable Ca and P. Given this information, consumers may be motivated to use milk and cheese to reduce, or reverse the cariogenic effects of many other foods.
Article
The purpose of this study was to assess the relationship between dietary patterns and dental caries severity in low-income African American children. The participants were 3- to 5-year-old African American children in Detroit, Mich, with household incomes below 250% of the 2000 federal poverty level (N=436). Dietary intakes were obtained using the Block Kids Food Questionnaire. Dental caries in primary teeth were measured by the International Caries Detection and Assessment System criteria. The mean number of decoyed surfaces (noncavitated and cavitated, missing, and filled surfaces [dmfs]) for each child was estimated. Factor analysis was carried out to identify the patterns of solid food consumption. The resulting factor scores and drink variables were then used as covariates in multinomial logistic regression, with 4 levels of dmfs as the outcome. Statistical analyses were conducted using SAS and SUDAAN. Multinomial regression models found that age, soda consumption, and powdered/sport drink consumption were positively associated with dmfs scores. Milk and real juice (not orange) were associated with lower dmfs levels. Children frequently consume sugared drinks, which is associated with the prevalence of dental caries. Intervention programs that promote the adoption of noncariogenic dietary alternatives for children are needed.
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